Qingwen Baidu Decoction For Sepsis With Syndrome Of Blazing Heat In Both Qi And Nutrient Phases

ObjectiveTo explore the effect of Qingwen Baidu Decoction,coagulation indexes,serum PCT,SOFA score,CDSS score and 28-day mortality are included in the observation.The observation aims to provide a clinical basis for the treatment of sepsis with syndrome of blazing heat in both qi and nutient phases.MethodSixty-four patients with sepsis admitted in Intensive Care Unit of Zhongshan Hospital Affiliated to Guangzhou University of traditional Chinese medicine from June 1,2020,to December 31,2020,who met the inclusion criteria,32 patients each in the observation and control groups.Thromboelastography indexes including R time,K time,angle,MA and CI,conventional coagulation indexes including platelet count,PT,APTT,D-dimer and fibrinogen,CDSS score,serum PCT,SOFA score,and28-day mortality were used as observation indexes.After admission,patients in both groups were given basic treatment of Western medicine,on the basis of which,patients in the observation group were given Qingwen Baidu Decoction for a week,while the control group did not use any Chinese medicine.Thromboelastography indexes,routine coagulation indexes,serum PCT,SOFA score,DIC incidence and28-day mortality were compared between two groups.Statistical analysis was performed with the SPSS 21.0 software.Result1.Comparison of thromboelastography indexes: R time,K time and angle of patients in two groups showed different trends and the differences were statistically significant(P < 0.01).After 7 days treatment,the level of MA in observation group is higher than those in control group(P < 0.01).The CI is significantly different in the coagulation state between two groups at day 7(P < 0.05).The coagulation state of control group was more severe than that in observation group.2.Comparison of conventional coagulation indexes: After treatment,platelet count,PT,APTT,D-dimer,and fibrinogen were significantly greater in both groups at day 3(P < 0.01),and the increase in fibrinogen in observation group was smaller than that in control group(P < 0.01).There were no significant differences in platelet count,PT,APTT,and D-dimer between two groups at day 3(P > 0.05).At day 7,platelet count,PT,APTT,D-dimer in two groups and fibrinogen in control group were increased(P < 0.01);the fibrinogen in observation group was reduced(P < 0.01).After one-week treatment,the level of platelet count,PT,D-dimer,and fibrinogen were lower in the observation group than in control group(P < 0.01),and APTT was shorter in observation group than in control group(P < 0.05).3.Comparison of serum PCT levels: The level of PCT showed no statistical differences between two groups at day 3(P > 0.05).Until day 7,the serum PCT in observation group was statistically lower than that in control group(P < 0.01).4.Comparison of SOFA score: SOFA score showed no statistical significance between two groups at day 3(P > 0.05).Until day 7,the SOFA score in observation group was statistically lower than that in control group(P < 0.01).5.Comparison of the incidence of DIC: After 7-day treatment,there was one case of DIC in observation group and six cases in the control group,but there was no statistical significance between two groups(P > 0.05).6.Comparison of 28-day mortality: the 28-day mortality is lower in observation group than in control group(P < 0.05).Conclusion1.Qingwen Baidu Decoction has a protective effect on the coagulation for sepsis with syndrome of blazing heat in both qi and nutient phases.The mechanism of effect may be related to reducing the inflammatory response,improving platelet function,and regulating fibrinogen activity,but not reducing the incidence of DIC in patients with sepsis.2.Qingwen Baidu Decoction combined with western medicine can improve the prognosis of sepsis with syndrome of blazing heat in both qi and nutient phases.